5x16 Ethics

[9.1/10] My favorite flavor of Star Trek episode is a moral thought experiment, and “Ethics” is chock full of them. Is it right to test an experimental therapy when the risks aren’t fully known? What about when there’s more safe and traditional, but less effective treatments? What about when you don’t fully trust the motivations of the physician offering them? There’s enough for medical ethicists to chew on here for a lifetime.

Beyond the purely medical, there’s all sorts of compelling questions around the broader idea of euthanasia. Should we allow someone who’s lost the will to live to end their own life? What if they’re paralyzed, but not terminally ill? What if they would be leaving a young child behind? What if there are cultural issues involved? What if they ask you as a dear friend to do something you deeply disagree with? The episode keeps stacking complication on complication for a central question that in and of itself has no easy answers.

Suffice it to say, I love it. “Ethics” puts its cards on the table by the end of the hour. Per TNG, bleeding edge medical testing is troubling even when it’s successful and euthanasia is wrong even when part of a cultural tradition. But even if you don’t buy those conclusions, I love watching our heroes grapple with the problem, and react to the emotional fallout of seeing someone they love maimed and face the real life consequences of it.

The whole shebang begins when a storage drum falls on Worf, paralyzing him. Worf asks Riker to help him end his life, as paralysis is considered shameful in Klingon culture. At the same time, Dr. Crusher calls in a neuro specialist, Dr. Russell, who offers a risky experimental treatment that promises to give Worf full control of his body again, but with a sixty percent risk of death.

That’s just the surface level of the issues involved. Along the way, we witness how much Worf has internalized his shame and sense of being an object of pity when he refuses to even let Alexander see him in this state. We watch Dr. Crusher push back on Dr. Russell’s “I’ll just 3D print you a spine” procedure and “You can’t stop progress” attitude. We see Riker, Troi, and Picard grapple with what losing their friend would mean and how to honor his wishes and his culture while honoring their own morals and feelings for him at the same time.

The result is a wonderful marriage of heady sci-fi thought-provocation and down home character work. Commander Riker in particular wrestles with his obligations to Worf as a friend, knowing (as Picard reminds him) that Klingons choose their friends carefully. It’s a terrible honor, then, to be asked to help one commit ritual suicide, especially under the circumstances. Riker makes sense as the choice (though there’s an argument for Picard), given their shared history and Riker’s direct experience with Klingons.

And yet, Will responds in the way you’d expect him too. He says he’d be willing to do it, even though he detests it, but he finds ways to meet Worf where he lives. He tells Worf that it would be an act of cowardice to turn away from this challenge, that it would be a shameful thing to do in light of the history of other Starfleet comrades who’ve fought for their lives and the people who care about him. And most of all, he finds how rules lawyer the situation and forces Worf to deal with the fact that, by right, it should be Alexander who has to assist his father in this grisly act. (Sidebar: They probably could have gotten Kurn.) The simple turning of the tables when it comes to rules and rituals forces Worf to confront what he wants to do in a more visceral way, and it’s a powerful method for addressing the full scope of what Worf is and isn’t considering in trying to make this choice.

But his isn’t the only decision here. Dr. Crusher has to decide whether, when push comes to shove, she will allow Dr. Russell to perform her experimental procedure on Worf, even when Worf professes to want it. It connects well with modern “right to try” laws, which grant the ability for patients to try non-FDA treatments when they’re facing terminal or other debilitating diseases. In this instance, Dr. Crusher takes on the role of lawmakers and ethicists, debating whether it’s right to allow such treatments to proceed given the risks, even if potentially desperate people want them. The show tips its hand in places, but on the whole does a good job of hearing out and dramatizing both sides of the argument.

More than those broad conduits for ideas, the episode does a good job of showing how this terrible accident and its aftermath affects the characters.For no one is this more true than Worf. The audience is in a terrible position to get Worf’s position, to be willing to die needlessly when he could still live a rich fulfilling life (and one with relatively good, albeit diminished mobility) simply because Klingon culture dictates. But as the episode progresses, we also understand, in a visceral way, how much learned shame he carries with him because of his debilitation, how it pains him to be seen as weak and in need, how he fears being a burden or source of pity to others.

It’s not exactly the same, but the episode carries the same emotional gravitas and sense of empathy it did with Timicin in “Half a Life”. Worf’s position is not one the viewer’s likely to share, but we do understand the emotional response and cultural context that informs his arguments and wishes on such a sensitive and personal subject. “Ethics” builds on what we know of the character, and throws this unimaginable circumstance at him to test the fault lines between his proud Klingon heritage and lifetime amid humans.

We also see it in Picard who is, frankly, a little out of character (or at least sidelined) here. Picard once again deploys a fair bit of cultural relativism, which seems true to form. If there’s been a consistent trait to Picard from the beginning, it’s a commitment not to judge other cultures for their rituals and traditions, no matter how strange or objectionable they may seem to humans. But the Picard I know would be on the front lines of telling Wrof that this is his choice and his captain will respect it, while also trying with everything in him to convince Worf he’s making the wrong call. (See also: “The Enemy”, and even “Redemption”.) But I can understand how the script needed Picard in more of the hands off father figure role he takes on here, with Riker taking the more hands on “brother” position in the proceedings.

What’s more, Troi gets a tremendous outing, as the show’s gotten better and better at using her outside of lead roles. She is, once again, fantastic as a connection between Worf and his son, trying to accommodate both parent and child’s needs while bridging the divide between them. It is incredibly moving when Worf himself recognizes this and asks Deanna if she would consider raising Alexander were something to happen to him. It’s a recognition of Troi’s talent at her job and ability to help both him and Alexander adjust to such a difficult new situation.

That just leaves Dr. Crusher herself, with Gates McFadden doing some all time great work here. Some friends of mine have been down on McFadden’s performance, but I think she proves her talents here. In the surgery scenes in particular, you can see the way Dr. Crusher is trying to preserve her professional detachment, at the same time she’s furious at her fellow physician and mourning a dear colleague. There’s complicated emotions at play in Beverly’s position as Chief Medical Officer, her role as a friend to Worf, and her broader status as an arbiter of what’s ethically right to do in this situation. It calls for a great deal of layered acting, and McFadden more than answers the call.

These swirling questions and considerations come to a head when Worf agrees to risk the procedure rather than continue seeking to take his own life, and Crusher agrees to allow the operation to move forward. There is immense tension as the work proceeds, and we witness Crusher, Russell, and Nurse Ogawa attempt this risky process to solve an otherwise incurable problem.

It shouldn’t be though. This is a fait accompli, as Worf’s return to health is almost guaranteed because of 1990s network television demanding a reversion to the status quo. And that’s before folks like me know that Worf shows up in later episodes no worse for wear. This should all feel like playing out the string, given how the destination seems all but certain.

But these scenes work for a variety of reasons. For one, there’s the background of the tension between Crusher and Russell. Beyond just Worf’s health, we see this as a test of judgment, even a battle of wills, between two physicians with very different ideas about how Worf’s recovery should proceed. It’s also aided by the score and editing, which use musical cues to rouse the audience’s concerns and well-placed cuts to create the sense of the passage of time and the urgency of what’s taking place.

More than that, we get to see Worf’s friends’ reaction to these events. We witness Picard and Riker trying to focus on business with the clear indication that their colleague’s fate weighs heavy on their minds. We see Troi trying to keep Worf’s son occupied during an immensely stressful time. We see Dr. Crusher slam her hands on the operating table and look like a wounded dove when she has to break the news to her patient’s loved one.

That is what really powers the emotional force of “Ethics” -- Alexander. As Riker raises with Worf, he isn’t just making this decision for himself; he’s making it for a child who needs him. Young Brian Bonsall does a stellar job showing Alexander’s respectful obedience to his father while also seeming quietly terrified and crestfallen about what lies ahead. And the moment where Worf seems to die is particularly piercing, as this young man seems to have yet another parent taken away from him prematurely. The jeopardy is false, but the emotions are real, which makes the stakes play out as genuine and gripping.
The episode even sets up the twist nicely, with Crusher and Russell talking about the duplicate organs and structures within Klingon anatomy, perfectly laying the groundwork for Worf’s to save the day despite an apparent flatline. It helps make his revival feel like less of a cheat, and creates a way for the show to briefly explore his loss and the costs of what would happen if these decisions had gone wrong, without having to radically change the show. Worf accepting help from his son, and the smile they share, shows yet more growth in the ol’ stoic Klingon. As is so often the case, having a child changes a person and their priorities.

But it doesn’t change Crusher. She is coldly furious at Dr. Russell, arguing that while such recklessness worked out, it comes at a moral cost. The point is made a little too directly for my tastes, but “Ethics” does a good job of dealing with the fall out from both choices, and how even when things work out, the closeness to disaster can caution against walking down that path again, and even indict those whose plans worked out. It’s a mixed blessing -- Worf is on the road to recovery, but due to questionable decisions and means, the kind of moral complexity that I admire in the best of Star Trek.

Make no mistake, “Ethics” deserves to be considered among the best of Star Trek. Its combination of those thorny moral dilemmas, its deeply-understood character motivations, and the intersection between the two when hypothetical situations become all to real makes it one of The Next Generation’s finest hours. At its best, Star Trek imagines the fantastical and brings it down to earth through the men and women who live through it. Thank god Worf lives through this, in every sense of the word.